Individual
JILL WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 GEORGIA ST STE C, LOUISIANA, MO 63353-2581
(573) 722-2213
Mailing address
1810 CRAIG RD STE 109, SAINT LOUIS, MO 63146-4758
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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